HomeMy WebLinkAboutwater damage 2015MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617) 723-3800 Ma Onlv (800) 392-6108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen, Laws. Ch.139, Sec.38
4t20t2016
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
ct,[Ao0021
02664
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$1000.00orcause@tobeapplicable.lfany
notice under Massachusetts General Laws. Chaoter'139. Section 38 is appropriate, please direct it to the
attention of the writer and include a reference to the captioned insured, Iocation, policy number, date of loss
and claim or file number.
l\4PlUA Claims Division
NANCY BANNISTER
54 ASTOR WAY. SOUTH YARMOUTH. MA
0810354
Water Damage: All Other Water Damage
0416nU6
405930
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number: